A “working” section of a medical endoscope may be a distal portion of the endoscope that is inserted into a patient, either through another instrument, or directly into an orifice, incision, or other entry point. In surgical applications, it is often desirable to decrease a working section diameter of instruments to reduce trauma and discomfort to a patient. An endoscope has a diameter that is large enough to contain all of the endoscope's functional components adjacent to one another. These components may include structural and protective members, optical elements, fibers to transfer light for illumination, and channels for instruments or fluid flow. Often a reduction in cross-sectional area of a given component translates into a reduction in functionality or performance of that component. Reducing the size of structural elements may reduce structural integrity and robustness. Smaller optical elements may result in reduced image quality. Fewer or smaller illumination fibres may lead to lower image brightness. Smaller channels may limit instrument compatibility and reduce the rate of fluid flow available to clear debris from an operative field. Consequently, a fundamental trade-off has typically existed in endoscope design between working section diameter and performance. One way to address these inherent limitations is to rigorously assess the functional requirements of the procedure and the needs of the customer to determine the optimal combination of size, functionality, and performance for a given application. Another approach is to develop smaller components that maintain the same or similar functionality and performance. For example, the size of rod lenses has been reduced while maintaining their optical performance. Miniaturized instruments have been developed that engage tissue with the same efficiency as larger devices. Alternative optical technologies, including fibre optic bundles and “chip-on-a-stick” cameras, have been developed that are less fragile and reduce the need for scope structural integrity. Additionally, the relationships between various components may be engineered to decrease overall endoscope size. However, many of these types of advancements present significant cost challenges.